That Was When People Started to Worry by Nancy Tucker

Nancy Tucker’s first book, The Time in Between (2015), was a wrenching and utterly absorbing eating disorder memoir told in an original blend of forms: cinematic scenes of dialogue and stage directions, schedules, tongue-in-cheek dos and don’ts, imagined interrogations, and so on. She’s recreated that experimental/hybrid style here to capture the experiences of young women with mental health challenges.

At a time when she was still struggling with anorexia and suicidal thoughts, bouncing between her uni room and a psychiatric ward, Tucker felt the need to get beyond her own pain by engaging with others’ problems. She interviewed 70 women aged 16 to 25 for a total of more than 100 hours and chose to anonymize their stories by creating seven composite characters who represent various mental illnesses: depression, bipolar disorder, self-harm, anxiety, eating disorders, PTSD and borderline personality disorder.

Each chapter follows a similar format, focusing on a first-person narrative from the invented character but also interspersing other documents like e-mails, instant messages, conversations with a therapist, a video interview transcript or a self-interrogation. A different font then sets out a few-page section that, in a sardonic tone, suggests the problem really isn’t that serious and is easily solved with a handful of simple tips. After this point Tucker steps out of character to give statistics and commentary on the particular mental illness, as she heard it described by her interviewees. She returns to the character’s voice to close with a “What I wish I could tell you about my [depression, etc.]” section, a heartfelt plea for sympathy.

These stories overlap with each other – anxiety and depression commonly co-occur with other mental illness, for instance. Yasmine’s bipolar means that sometimes she feels like she could run a marathon or write a novel in a few days, while other times she’s plunged into the depths of depression. Neither Abby (depression) nor Freya (anxiety) can face going to work; Maya (BPD, also known as emotionally unstable personality disorder) exhibits many of the symptoms from other chapters, including self-harm and feelings of emptiness.

Tucker is keen to emphasize how complex these disorders are: it’s never just a matter of being sad, having mood swings or seeking attention. She is sensitive to the way that certain ones might be belittled, such as binge eating disorder, which, because it isn’t as clinically recognized as anorexia or bulimia, can be equated with poor self-control. Also, mental health conditions exist on a continuum, so it’s hard to definitively announce a cure. In any case, “A binary perception of mental illness benefits no one,” Tucker explains: “the ‘insane’ may find themselves held at arms’ length, but the ‘sane’ may be denied rapid treatment, or accused of melodrama.”

The details of these narratives can be painful to read, like Georgia and friends browsing Tumblr for ideas of how to cut themselves with razors and take not-quite-overdoses of paracetamol, and Holly’s post-traumatic stress after not-quite-consensual sex with her boyfriend. But the voices are so intimately rendered, and the chapters so perfectly balanced between the general and the fictionalized particulars, that they illuminate mental health crises in a uniquely powerful way.

Reading this has helped me to understand friends’ and acquaintances’ behavior. I’ll keep it on the shelf as an invaluable reference book in the years to come. Based on what I’ve read thus far, this is my frontrunner for next year’s Wellcome Book Prize, which “aims to excite public interest and encourage debate around [medical] topics.” That Was When People Started to Worry seems to me to be just what the prize is looking for, as “Books that find stories in those brushes with medicine are ones that add new meaning to what it means to be human.”

My rating:

That Was When People Started to Worry: Windows into Unwell Minds was published by Icon Books in May. My thanks to the publisher for a free copy for review.

Just the title would have been enough to get me to pick this up.
‘Unwell minds’ seem to be epidemic these days, so everyone, at some time or other, is going to end up interacting with people with mental health issues. This seems like a ‘must-read.’

This sounds like a really fantastic book dealing with some important issues. I’ve heard of the Wellcome Book Prize, but I hadn’t realized it was focused on books have to do with medicine. I’ll have to pay more attention to it in the future!